International Telecommunication Union Workshop on Standardization in E-health Geneva, May 2003 H.323 for Telemedicine Paul E. Jones Rapporteur, ITU-T Q2/16 Cisco Systems, Inc.

ITU-T May 2003 Workshop on Standardization in E-health What is H.323? o H.323* is the international standard for multimedia communications over packet- based networks, including the convergence of voice, video, and data communications *H.323 is ITU-T Recommendation H.323: Packet-based multimedia communications systems

ITU-T May 2003 Workshop on Standardization in E-health Where did H.323 Come From? o Recommendation H.323 is a standard published by the International Telecommunications Union Telecommunications Sector (ITU-T) Formerly known as CCITT Refer to A permanent organ of the United Nations System (refer to

ITU-T May 2003 Workshop on Standardization in E-health A Little About the Origins… o H.323 was originally scoped to be a protocol for the Local Area Network (1996) Local Area Network Or was it?

ITU-T May 2003 Workshop on Standardization in E-health Origins (cont.) o The first thing people tried to do was use H.323 in wide area networks, large private VoIP networks, and over the Internet

ITU-T May 2003 Workshop on Standardization in E-health Origins (cont.) o H.323 was an early adopter of such IETF protocols as RTP, which proved its ability to carry real-time audio and video over IP networks that span the globe o Indeed, H.323 was much more than a LAN protocol

ITU-T May 2003 Workshop on Standardization in E-health Origins (cont.) o Recognizing that H.323 was much more than a LAN protocol, evolution and improvement of the H.323 protocol continued (and is continuing) within the ITU-T

ITU-T May 2003 Workshop on Standardization in E-health H.323 versus H.320 o H.320 is similar to the H.323 protocol in that it provides voice, video, and data communications o H.323 differs in that it is designed for communication over a packet-switched network, such as the Internet, an enterprise LAN, or other IP-based network, whereas H.320 is designed for use over ISDN o Why H.323 over H.320? ISDN is inexpensive to own, but expensive to use… The availability of flat-rate pricing for IP videoconferencing, on the other hand, allows calls at bandwidths too expensive for ISDN, including some IP calls up to 2 Mbps and beyond. – Frequently Asked Questions About Voice and Video over IP Networks, Wainhouse Research and Margalla Communications (January 2003) An IP network in the enterprise may be utilized for voice, video, and data, thus potentially lowering the overall communications (both capital expenses and operational expenses) H.323 equipment can utilize existing IP-based services, including IP- based voic services, LDAP directories, DNS, web-based collaborative tools, etc.

ITU-T May 2003 Workshop on Standardization in E-health Evolutionary History of H.323 o H.323 version 1 was first approved in 1996, with a focus on enterprise voice, video, and data collaboration o H.323 version 2 was approved in 1998, with a focus on Internet Telephony o H.323 version 3 was approved in 1999 with incremental improvements o H.323 version 4 was approved in 2000 with major enhancements focused on the requirements of service providers o H.323 version 5 (scheduled for approval in May 2003) focuses on maturity and stability

ITU-T May 2003 Workshop on Standardization in E-health Version Interoperability o While H.323 has been revised a number of time, focus has always remained on backward compatibility o Each new major version introduced a number of new features, but did not sacrifice interoperability o Even so, interoperability events have been necessary to ensure vendor interoperability, with output of those meetings going as input into the SG16 process o At every meeting, an updated H.323 Implementers Guide is published to provide corrections and guidance to implementers of the protocol

ITU-T May 2003 Workshop on Standardization in E-health A Cry for Stability… Heard o Enterprise and service providers have requested stability, citing a real need for a mature protocol that is not a moving target o H.323 version 4 introduced a new extension mechanism, referred to as the Generic Extensibility Framework (GEF) that facilitates the addition of new features without making changes to the core standards o All new features that are not considered horizontally useful are being added as separate, optional extensions via the GEF mechanism

ITU-T May 2003 Workshop on Standardization in E-health H.248: Scalability of the Gateway Media Gateway Controller (Softswitch) H.323 H.248 SCNRTP Media Gateway SCNRTP Media Gateway SCNRTP Media Gateway SCNRTP Media Gateway SCNRTP Media Gateway SCNRTP Media Gateway

ITU-T May 2003 Workshop on Standardization in E-health Todays H.323 Network Topology Service Provider IP Core Network GK Video Terminals Enterprise GK H.323 PSTN Gateways GK Directory Gatekeepers GK H.248 PSTN Gateways MGC Audio and Video Terminals GK

ITU-T May 2003 Workshop on Standardization in E-health Ongoing Work o LDAP schema specifications o Definition of usage of the H.323 URL, allowing the use of DNS and ENUM with H.323 o Enhanced third-party call control o Quality of Service o Scalability and robustness enhancements o Short message service

ITU-T May 2003 Workshop on Standardization in E-health Voice, Video, and Data Communications from Day 1 o H.323 was designed to be a multimedia communications protocol from the outset and not limited only to audio o As such, H.323 provides very tight integration of audio, video, and data communications functionality

ITU-T May 2003 Workshop on Standardization in E-health Where We are Today o Voice, video, and data conferencing capability o T.38 fax support o Modem over IP support o Many supplementary services defined o Strong interoperability with other H.32x systems, including H.320 (ISDN) and H.323M (3GPP mobile wireless) o Specification of media gateway decomposition (via H.248) o Support for signaling and media security o User, terminal, and service terminal mobility o Support for emergency services signaling

ITU-T May 2003 Workshop on Standardization in E-health Where We are Today (cont.) o Extremely wide deployment o Billions of minutes of traffic per month worldwide (counting public networks only) o More than 90% of all voice over IP traffic today is H.323 o Nearly 100% of the video over IP traffic today is H.323

ITU-T May 2003 Workshop on Standardization in E-health Where is H.323 Used? o Wholesale transit o Calling Card o Voice Conferencing o Voice VPNs o Unified Communications o IP-PBX o PC-to-phone o Video conferencing o Distance Learning o Call center o IP-Centrex o Mobility services o Custom news / info o Voice/Data/Video Collaboration o Broadband residential o More…

ITU-T May 2003 Workshop on Standardization in E-health Industry Support o Hundreds of service providers and equipment manufacturers supporting H.323 o H.323 market still growing strongly o Voice over IP has been the market driver in recent years o Video over IP is now becoming more popular than ever, with deployments in several service providers

ITU-T May 2003 Workshop on Standardization in E-health H.323 Forum o The H.323 Forum was founded in 2002 o Sponsored by the International Multimedia Telecommunications Consortium (IMTC)

ITU-T May 2003 Workshop on Standardization in E-health H.323 Forum Activities o Equipment certification requirements o Live conferences (two or three per year) o Video conferences (three or four per year) o Strategic press releases o Organized presentations at other conferences

ITU-T May 2003 Workshop on Standardization in E-health Notable H.323 Forum Events o January 2002: IMTC approves the formation of the H.323 Forum as a part of its organization o May 2002: H.323 Forum kick-off in Geneva and a web site o June 2002: H.323 Forum at Collaborative East o August 2002: Certification levels 1a/1b defined o September 2002: First worldwide H.323 Forum video conference was held o October 2002: H.323 Forum at VON o October 2002: ETSI and OSP users group support H.323 Forum o November 2002: H.323 Forum at Collaborative West o November 2002: First H.323 Forum industry conference o March 2003: Second worldwide H.323 Forum video conference was held

ITU-T May 2003 Workshop on Standardization in E-health Additional Information o Packetizer o H.323 Forum o OpenH